Individual
DR. JAMES NELSON BOWERS DILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
220 MANHATTAN AVE APT 6F, NEW YORK, NY 10025-2666
(917) 653-6677
Mailing address
220 MANHATTAN AVE APT 6F, NEW YORK, NY 10025-2666
(917) 653-6677
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
013205
NY
103TA0700X
Adult Development & Aging Psychologist
013205
NY
103TB0200X
Cognitive & Behavioral Psychologist
013205
NY
103TC0700X
Clinical Psychologist
Primary
013205
NY
103TC2200X
Clinical Child & Adolescent Psychologist
013204
NY
103TM1800X
Intellectual & Developmental Disabilities Psychologist
013205
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013205
PSYCHOLOGY LICENSE STATE
NY
Enumeration date
07/13/2007
Last updated
07/13/2007
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